Organization
EVOLVE DENTAL MEDSPA
Active
Parent organization
CRYSTAL CLEAR FAMILY DENTISTRY
Other names
Evolve Dental MedSpa
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRYSTAL CLEAR FAMILY DENTISTRY
Authorized official
MISS ALEXA LANVIN (OFFICE MANAGER)
(615) 930-2050
Entity
Organization
Contact information
Practice address
1210 HAZELWOOD DR STE B, SMYRNA, TN 37167-3964
(615) 930-2050
Mailing address
415 AVONDALE DR, NASHVILLE, TN 37206-1818
(615) 584-3861
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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